76-year-old Iranian Male Decision Point One

Alzheimer’s Disease
76-year-old Iranian Male
Decision Point One
Begin Razadyne (galantamine) 4
mg orally BID
 // Alzheimer’s Disease
RESULTS OF DECISION
POINT ONE
Client returns to clinic in four
weeks
The client is accompanied by his
son who reports that his father
is “no better” from this
medication
He reports that his father is still
disinterested in attending
religious services/activities,
and continues to exhibit
disinhibited behaviors
You continue to note
confabulation and decide to
administer the MMSE again.
Mr. Akkad again scores 18 out
of 30 with primary de!cits in
orientation, registration,
attention & calculation, and
recall
DecisionPoint
Decision Point Two
Discontinue Razadyne and
begin Exelon (rivastigmine) 1.5 mg
orally BID
RESULTS OF DECISION
POINT TWO
Client returns to clinic in four
weeks
Client’s son reports that the
client is tolerating the
medication well, but is still
concerned that his father is
no better
He states that his father is
still not interested in
attending religious services
with the family, and he is
still concerned that his
father is still easily amused
by things he once found
seri
Decision Point Three
Augment with Namenda 10
mg orally at BEDTIME
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